Screening and Referral in Integrated Health Systems

Primary care practitioners are urged to screen patients for mental and substance use disorders to improve health outcomes for individuals and communities.

Untreated chronic disease is a major factor in the overall higher cost of care for people with mental and/or substance use disorders. The likelihood that someone seeking behavioral health care services will successfully complete a referral to a primary care facility is low in general but greatly improved within a single visit to a primary care facility. Primary care and specialty practitioners (such as cardiologists, oncologists, gerontologists, endocrinologists, and other health specialties in which patient care can be affected by behavioral health issues) are urged to screen patients for depression, drug and alcohol use, bipolar disorder, suicide risk, and anxiety disorders.

The Screening, Brief Intervention, and Referral to Treatment (SBIRT) process can help providers in primary care and other health care settings to assess the severity of substance use, depression, and other behavioral health issues, and identify the appropriate level of treatment. Referral to treatment is a critical yet often overlooked component of the SBIRT process. It involves establishing a clear method of follow-up with patients identified as having a possible addiction or in need of specialized treatment for a mental health condition. It also involves helping patients overcome any economic, transportation, or other barriers to treatment.